A 60-year-old requires periodontal therapy. On examination there is a localized periodontal abscess with active purulent exudate. What should be done FIRST?

Correct answer: C. Drain and manage the acute abscess

• A. ❌ Full-mouth SRP is Phase I therapy, delivered AFTER acute problems are controlled. Instrumenting around an untreated abscess is painful and less effective.
• B. ❌ Deferring an actively suppurating abscess for a month risks spread of infection and further bone loss.
• C. ✅ CORRECT — Acute infection is always addressed in the URGENT phase, before the systemic (hygiene) phase. Drainage — through the pocket or by incision — plus debridement of the involved site relieves pain, halts rapid attachment destruction, and lets definitive therapy proceed on an uninflamed field.
• D. ❌ Surgery is Phase II and requires resolved acute inflammation and a re-evaluated tissue response.

Note: Phase order: (0) Urgent/acute → (I) Systemic/hygiene phase incl. SRP → re-evaluation → (II) Surgical → (III) Restorative → (IV) Maintenance.